THE IMPORTANCE OF EARLY INTERVENTION by Ms. Pamela Manu

In recent times, there has been a notable increase in statistics of children with autism. The United States Center for Disease Control (CDC) states that cases of children with autism has increased from 1 in 88 to 1 in 68 children. With the rise in the cases of autism, more and more families are faced with the challenge of accessing intervention programs for their children with autism.

When you hear “early intervention,” some questions come to mind. I would attempt to answer some of them.

Q. How early should I start intervention?

To put it simply, intervention should start as early as possible. When parents begin to notice that their child is not developing as expected and they voice these concerns, a common response is, “They’ll grow out of it, just wait.” Unfortunately, the longer you wait the more difficulty you and your child may have eventually. If you are concerned about your child’s development, whether it’s their communication, social skills or behaviours, then you should begin seeking information and assistance as soon as you can.

The earlier a problem is identified, the earlier intervention can begin, and the more likely your child is to learn the skills they need to communicate engage in social interactions and manage their behaviour. If you’re still waiting for an official diagnosis, you shouldn't be waiting to start intervention. If you think there is something that needs to be addressed, get the information, services and training you need to address it.

Q. Why start intervention so early?

Research shows that children who receive intensive early intervention services are more likely to have improved long-term outcomes. These services can maximize their learning potential by addressing communication, play, problem behaviours and overall skill development from a very early age. We know, through extensive research on the human brain, that neural plasticity (the brain's ability to learn new skills) decreases with age. When children are very young their neural plasticity is high, but as they get older it decreases. When this plasticity decreases, it becomes more difficult to learn new skills.

This is not to say that individuals with autism are not able to learn skills if intervention is not started by a certain age. Their brains, just like everyone else’s, are capable of learning and using new skills and information at any time. Behaviourally speaking, however, as we all age and grow the skills we have learned which are effective and efficient will be more difficult to change due to a longer history of reinforcement. So the earlier we intervene to address an individual’s difficulties with communication, social interactions and problem behaviours the more likely we are to elicit quick and positive change.

Q. How much intervention should my child receive?

Research suggests that children should receive 25-40 hours of intensive early intervention per week. While this may seem like an extraordinary amount of time for a child, this intensity of intervention has been shown to be the most effective in addressing the needs of children. Intervention hours may be provided by ABA therapists, speech therapists, occupational therapists, parents or other family members (after receiving training on intervention implementation) or other service providers. In an ideal situation, intervention procedures should be implemented throughout the day, across settings and across people with whom the child interacts. This intensity and consistency of intervention can help catapult a child to success.

Q. What are the goals of early intervention?

The basic goals that should be addressed with early intervention are child engagement, independence, functional spontaneous communication, cognitive skill development, social competence, play skill development, generalization of skills, and proactive approaches to problem behaviour. The specific goals for intervention will be based on the child’s chronological age, developmental level, specific strengths and weaknesses, and the needs or priorities of their family.

Q. What interventions are available and most effective?

There is no single treatment protocol for all children with autism, but most individuals respond best to highly structured behavioural programs. The National Institute of Child Health and Human Development lists Applied Behaviour Analysis among the recommended treatment methods for autism spectrum disorders. Some of the most common interventions are Applied Behaviour Analysis (ABA), Speech and Language Therapy, Occupational Therapy, PECS, AAC, Sensory Integration Therapy and the school-based TEAACH method.

 Q. How do I know if an intervention is effective?

The only way to know for certain an intervention is effective is to see the data. These data should be collected and reported to you as a parent on a frequent basis. If there is no data to support the efficacy of the intervention, then you are right to question whether or not the intervention should continue. Data provide us the capability to make timely decisions about interventions. For instance, if the data show the child is not making significant improvements in the expected time frame, we might consider changing something about the intervention. If, on the other hand, the data show the child is making the expected gains we know we’re on the right track. If interventionists are not collecting data, there is no way to quantify change and there is no way to make informed decisions about the efficacy of the interventions being used.

Q. How involved should I be in my child’s intervention?

Your participation as a parent is vital to your child’s success. This may seem like a bold statement, but the truth is that if you are not involved in your child’s therapy programs the likelihood of success is much lower. This is because when you are involved in the development and implementation of interventions the intervention procedures are more likely to be used across contexts and people and your child is likely to learn and use skills more quickly. If on the other hand, teachers and therapists develop and implement interventions but these interventions are not supported or implemented at home the skills are likely to be learned slower and the likelihood of them having long term benefit is going to be small.

As parents, you are the people who spend the most amount of time with your child. You should be integrally involved in the development of interventions, and you should receive extensive training from the professionals who work with your child so you also know how to implement the interventions well. Don’t settle for a simplified explanation of the intervention plan with no hands-on training. The professionals working with your child should be showing you and teaching you how to work with your child. This doesn't happen as much as it should and this can be detrimental to the progress of your child. It is important that you really know how to implement the intervention so you can support what the therapist(s) working with your child are doing and help your child generalize the skills they are learning.

If you wish to learn more about Early Intervention services and the benefits to a child with Autism Spectrum Disorders, you may begin by attending the C.A.D.E.T. Academy FREE autism seminar, tomorrow, Saturday 12 April 2014. The venue is: SRC Meeting Room, 10b Owena Close, off Yedseram Street, Maitama, Abuja. The seminar starts at 11am and would last for 2hours.